MEDICARE: SHAYRANISSE PAGAN CRUZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	31438	FL
2	208D00000X	General Practice Physician	19699	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386182632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYRANISSE PAGAN CRUZ MD

Provider Business Mailing Address
First Line	:	9066 SW 73RD CT APT 1202
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-2968
Country	:	US
Telephone Number	:	787-384-8442
Fax Number	:

Provider Business Practice Location Address
First Line	:	9066 SW 73RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-2964
Country	:	US
Telephone Number	:	787-384-8442
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2017
Last Update Date	:	05/14/2024

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